Anti-depressive effects have been noted in woman with major depressive disorder when 5g of creatine monohydrate was supplemented daily for 8 weeks in combination with an SSRI. Benefits were seen at week two and were maintained until the end of the 8-week trial.[253] The improvement in depressive symptoms was associated with significantly increased prefrontal cortex levels of N-acetylaspartate, a marker of neuronal integrity,[254] and rich club connections, which refers to the ability of nerons to make connections to one another.[255]
Every 4-8 weeks, vary your routine. As your body adapts to stress, you'll hit a plateau where the benefits of weight training will begin to diminish. The only way to prevent this from happening is to change things up, such as by increasing weight and changing exercises. Try a week of really piling the weights on, and do six to eight reps per set at the maximum weight you can manage with proper form. The more lifting experience you have, the more often you should vary your routine.
Although muscle stimulation occurs in the gym (or home gym) when lifting weights, muscle growth occurs afterward during rest periods. Without adequate rest and sleep (6 to 8 hours), muscles do not have an opportunity to recover and grow.[citation needed] Additionally, many athletes find that a daytime nap further increases their body's ability to recover from training and build muscles. Some bodybuilders add a massage at the end of each workout to their routine as a method of recovering.[50]
Han:SPRD‐cy rats (human polycystic kidney disease model[514][515]) have pre-existing renal damage, which is accelerated upon ingestion of creatine supplementation at 0.3% of the diet for five days and 0.03-0.05% for the next 35 days (equivalent to human loading and maintenance).[516] During this particular disease state, renal water content and size progressively increases.[514][515] Since creatine supplementation furthered the increase by an additional 2.1%, it was thought that this property of creatine explained the 23% increased cyst scores seen relative to control.[516]

In regard to the blood brain barrier (BBB), which is a tightly woven mesh of non-fenestrated microcapillary endothelial cells (MCECs) that prevents passive diffusion of many water-soluble or large compounds into the brain, creatine can be taken into the brain via the SLC6A8 transporter.[192] In contrast, the creatine precursor (guanidinoacetate, or GAA) only appears to enter this transporter during creatine deficiency.[192] More creatine is taken up than effluxed, and more GAA is effluxed rather than taken up, suggesting that creatine utilization in the brain from blood-borne sources[192] is the major source of neural creatine.[193][192] However, “capable of passage” differs from “unregulated passage” and creatine appears to have tightly regulated entry into the brain in vivo[193]. After injecting rats with a large dose of creatine, creatine levels increased and plateaued at 70uM above baseline levels. These baseline levels are about 10mM, so this equates to an 0.7% increase when superloaded.[193] These kinetics may be a reason for the relative lack of neural effects of creatine supplementation in creatine sufficient populations.
Eat 1.5–3 grams of carbs per pound of your body weight. As with fat, this amount can vary greatly, depending on your personal needs and preferences, so consider these numbers only a starting point. If you’re very skinny and feel that you handle carbs well (i.e. you can eat a lot of them without getting fat), go ahead and eat according to the higher end of the spectrum. The same applies if you’re desperate to gain weight—you should increase your carb intake. If you’re prone to weight gain or feel lethargic on higher carbs, you should eat fewer of them. Again, see our keto guide for more details and options.
It is known that intracellular energy depletion (assessed by a depletion of ATP) stimulates AMPK activity in order to normalize the AMP:ATP ratio,[333][334] and when activated AMPK (active in states of low cellular energy[335] and colocalizes with creatine kinase in muscle tissue[336]) appears to inhibit creatine kinase via phosphorylation (preserving phosphocreatine stores but attenuating the rate that creatine buffers ATP). While phosphocreatine technically inhibits AMPK, this does not occur in the presence of creatine at a 2:1 ratio.[334] It seems that if the ratio of phosphocreatine:creatine increases (indicative of excess cellular energy status) that AMPK activity is then attenuated, since when a cell is in a high energy status, there is less AMP to directly activate AMPK.[334][336][337]
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